1 Serogroups and genotypes of Leptospira spp. strains from bovine aborted fetuses 2 Delooz Laurent1,2, Czaplicki Guy1, Gregoire Fabien1, Dal Pozzo Fabiana2, Pez Floriane3, Kodjo 3 Angeli4, Saegerman Claude2 4 1 Regional Association for Animal Registration and Health (ARSIA) asbl, 5590 Ciney, Belgium 5 2 Research Unit of Epidemiology and Risk Analysis applied to veterinary science (UREAR- 6 ULg), Fundamental and Applied Research for Animals & Health (FARAH) Center, Faculty of 7 Veterinary Medicine, University of Liege, 4000 Liege, Belgium 8 3 BioSellal, 69007 Lyon, France 9 4 Laboratoire des Leptospires, VetAgro Sup, Campus Vétérinaire de Lyon, 69280 Marcy- 10 l’Etoile, France 11 12 ABSTRACT 13 Leptospirosis is a global disease of animals, with potential major economic impact on livestock 14 industry and important zoonotic capacities. The disease represents a major challenge in the 15 developing countries as humans and animals frequently live in close association. The serovar 16 Hardjo of Leptospira whose primary host is cattle has been studied extensively, but few data 17 exist on other current circulating or emerging serotypes. To better understand the disease in 18 cattle and how to prevent and/or control it, it is necessary to identify the genotype and the 19 serotype of circulating Leptospira. This paper presents results of several investigations 20 performed on a historical Belgian collection of congenital jaundice in bovine aborted fetuses 21 coming from the leptospirosis emerging episode of 2014 (Delooz et al., 2015). The results 22 revealed that L. Grippotyphosa and L. Australis were the most prevalent serogroups with 23 respectively 17/42 and 13/42 positive MAT during this emerging event associated with the 24 same clinical pattern. The study also confirms that congenital jaundice is associated with L. 25 kirscheneri and L. interrogans and provides the genotyping of DNA obtained from these two 26 species. 27 Keywords: Abortion, Cattle, Icteric, Jaundice, Genotyping, Leptospira, Leptospirosis, 28 Belgium 29 30 INTRODUCTION 31 In Belgium, a national surveillance program based on the compulsory reporting of 32 abortions and subsequent analyses on their products reached several objectives including 33 official surveillance of bovine brucellosis but also the monitoring of other bovine abortive 34 diseases. Some emerging or re-emerging pathogens could be identified, including Bluetongue 35 virus serotype 8, Brucella abortus and more recently Schmallenberg virus. 36 Since July 2014, the Belgian Walloon region faced an unexpected situation with a 37 drastic increase of congenital jaundice in bovine aborted fetuses (Delooz et al., 2015). During 38 the last six years, abortions associated with jaundice had been notified but the monthly 39 incidence of cases remained stable. From July to December 2014, an increase of bovine aborted 40 fetuses with jaundice was reported by ARSIA pathologists, with a significantly higher incidence 41 than previous months and years. The standardized panel of analyses designed to extend the 42 diagnosis did not allow identifying the etiology. After additional analyzes, high levels of 43 antibodies against Leptospira serogroups Australis and Grippotyphosa were found in cows after 44 abortion of icteric fetuses. Serology performed during the emergence identified serogroups 45 without providing information on the genotype of the involved pathogenic Leptospira strains. 46 A leptospiral infection was consequently hypothezised (Delooz et al., 2015). 2 47 Leptospirosis is a transmissible disease of animals and humans caused by the spirochete 48 Leptospira. All the pathogenic leptospires were formerly classified as members of the species 49 Leptospira interrogans. However, the genus has been reorganised and pathogenic Leptospira 50 are now classified in 23 species (Adler, 2010; Levett, 2001; Morey et al., 2006) from which 51 more than 300 distinct serovars included within 24 serogroups are distinguished (Levett, 2015). 52 Laboratory diagnosis of leptospirosis can be complex and involves tests designed to detect 53 specific antibodies against Leptospira, as well as for direct isolation of leptospires, antigens 54 detection and detection of Leptospira nucleic acid in animal tissues or body fluids (OIE, 2014). 55 In cattle, the seroprevalence of the serogroup Sejroe is one of the most studied and varies 56 widely from one country to another with 33% in France (Ayral et al., 2014), 30% in the 57 Netherlands (Hartman et al., 1989) and up to 83.59% in Ireland (Ryan et al., 2012). In addition, 58 antibodies against Leptospira serovar Hardjo were found in tank milk of 9.2% bovine dairy 59 herds, with a higher incidence in the southern part of the country (Dom et al., 1991). In France, 60 microscopic agglutination test (MAT) performed on samples collected in 394 cattle herds 61 allowed to determine the distribution of the following three predominant circulating serogroups 62 (Australis, Sejroe, and Grippotyphosa) (Ayral et al., 2014). In this part of Europe, leptospirosis 63 is prevalent and may be responsible for pathological events in human (Mori et al., 2014) and 64 animal health (Delooz et al., 2015). 65 Leptospirosis is a known cause of abortions and infection can be accompanied by a wide 66 variety of clinical signs. However, fetal jaundice was not observed during experimental 67 infections (Ellis and Michma, 1977; Ellis et al., 1986; Smith et al., 1997). On the contrary based 68 on the recent field observations, the hypothesis of the association of bovine fetal jaundice with 69 leptospirosis was formulated (Delooz et al., 2015). Currently, little epidemiological information 70 exists concerning the different serovars of Leptospira circulating among cattle in Belgium. 71 While the manifestations of the disease can be very different depending on the strain and the 3 72 animal species, it is important to identify the pathogenic strain in order to tackle the best 73 prevention and control measures and thereby, prevent potential transmission to humans 74 (Evangelista and Coburn, 2010). 75 76 The aim of this work was to characterize the Leptospira infection detected in bovine abortion cases associated with fetal jaundice which occurred in Southern Belgium in 2014. 77 78 MATERIAL AND METHODS 79 Study desing 80 In the context of the Belgian passive surveillance program for bovine brucellosis, a total 81 of 42 bovine abortion cases collected from October 2011 to December 2014 were included in 82 this study. They originated from 39 cattle farms distributed among the 5 Walloon provinces. 83 They were included in the study according to the diagnosis of congenital jaundice (N = 41) or 84 the PCR positivity against pathogenic Leptospira (N = 1). 85 Information issued from the anamnesis, such as sampling date, herd identification 86 number, cattle breed, month of pregnancy and number of parity were encoded in the laboratory 87 information management system (LIMS) or in an Access database. None of these herds 88 applied vaccination against Leptospira species and, moreover, no Leptospira vaccine has a 89 marketing authorization in Belgium. The geographical localization of each case of abortion was 90 possible using the Lambert coordinates and the Belgian cattle identification and movement 91 traceability system (SANITRACE). 92 93 Laboratory analyses 94 A standardized panel of analyses was first applied to perform the laboratory diagnosis 95 of bovine abortion on submitted fetuses. Direct and/or indirect detection of pathogens was 96 performed, including bacteria (Brucella spp., Campylobacter spp., Coxiella burnetii, 4 97 Leptospira borgpetersenii and interrogans serovar Hardjo, Listeria monocytogenes, Neospora 98 caninum, Salmonella Dublin), viruses (bluetongue virus serotype 8 (BTV-8), bovine 99 herpesvirus 1 (BoHV-1), bovine herpesvirus 4 (BoHV-4), bovine viral diarrhea virus (BVDV), 100 Schmallenberg virus), several mycotic agents, and many other opportunistic bacteria (Table I). 101 102 Microscopic agglutination tests 103 MAT was performed on the 42 maternal sera sampled on the aborted cows at the time of 104 abortion using twenty-four serovars representing 14 serogroups of pathogenic Leptospira 105 species: Icterohaemorrhagiae, Copenhageni, Australis, Bratislava, Munchen, Autumnalis, Bim, 106 Castellonis, Bataviae, Canicola, Hebdomadis, Panama, Mangus, Pomona, Mozdok, Pyrogenes, 107 Sejroe, Saxkoebing, Hardjo, Wolffi, Tarassovi, Cynopteri, Vanderhoedoni, and Grippotyphosa 108 (Table II). According to observations recorded by Chappel and collaborators in 2004, titers of 109 160 or higher were defined as positive agglutination reactions for ruminants. The end-point was 110 the highest dilution of serum in which 50% agglutination still occured. 111 112 Pathogenic Leptospira DNA detection (real-time PCR). 113 During the necropsy, a spleen, kidney, liver and placenta fragment were sampled on 114 each abortion cases, pooled and stored at -20°C. PCR analysis was performed on 26 pools of 115 organs sampled from icteric fetuses, retrieved in the historical abortion samples collection 116 described in the study design (not available for 16 other fetuses). DNA extraction was 117 performed using KingFisher 118 UK) and LSI MagVet TM Universal Isolation Kit (Life Technologies, UK) and was followed by 119 pathogenic Leptospira DNA detection using a commercial PCR test (TaqVet TM PathoLept TM, 120 Thermofisher, France) on organ pool according to the manufacturer's instructions (Levett et al., 121 2005). TM Flex 96 Magnetic Particle Processors (Thermo Scientific TM , 5 122 The PCR reactions were performed with a Stratagene Mx3500P (Agilent Technologies, 123 USA). According to the manufacturer's instructions, a sample was considered positive with a 124 threshold cycle (= Ct) value lower than 46. 125 126 Leptospira genotyping method by multilocus sequence typing (MLST) by Next-Generation 127 Sequencing (NGS) 128 Among 10 randomly selected samples (i.e. PCR real-time positive group), genotyping was 129 realized in the Biosellal laboratory of Lyon (France) according to the consensus MLST scheme 130 developed by Boonsilp and collaborators (2013). Obtained PCR amplicons were purified using 131 1.8X Agencourt AMPure XP beads (Beckman Coulter). Qubit fluorometer 2.0 (Life 132 technologies) was used to quantitate and normalize amplicon concentrations, accounting for the 133 different amplicon fragment lengths; this was followed by equimolar pooling of all MLST loci 134 for each sample. 135 Preparation of Illumina libraries was performed with 1 ng of pooled amplicons according to the 136 Nextera XT protocol (Version January 2015) and libraries were sequenced using the MiSeq 137 Personal Sequencer (Illumina). Bio-Informatic analyses were performed using CLC Genomics 138 Workbench (CLC Bio, Qiagen, Aarhus, Denmark). 139 The combination of the sequences of these seven loci was compared with a public database, the 140 Leptospira spp. MLST Databases. This publication made use of the Leptospira MLST website 141 (http://pubmlst.org/leptospira/) developed by Keith Jolley and sited at the University of Oxford 142 (Jolley and Maiden, 2010). This is located at the Imperial College of London and was funded 143 by the Wellcome Trust using Boonsilp and collaborators (2013) protocols (MLST scheme 1) to 144 determine the species of Leptospira and serogroup. Briefly, each sequenced MLST locus for 145 one sample was assigned to allele numbers and combined into an allelic profile which is then 146 assigned to a unique sequence type (ST). 6 147 148 RESULTS 149 Among the 42 abortion cases, using the standardized panel of analyses (Table I), it was 150 possible to identify one pathogen in 11 cases, Anaplasma phagocytophilum (1), Coxiella 151 burnetii (2), Neospora caninum (1) including 7 opportunistic bacteria such as Escherichia coli 152 (5), Hafnia alvei (1), and Lactococcus lactis (1). Only one maternal serum was seropositive for 153 the Leptospira serovar Hardjo Elisa but the MAT revealed negative results for all the tested 154 serogroups including for serovar Hardjo with low titers of 40. 155 156 Microscopic agglutination tests 157 Among the 42 samples of maternal serum, 29 had a positive result with respect to at 158 least one serogroup (Table III). Among the positive samples, agglutination was observed 159 against an average of 2 and a maximum of 5 serogroups per sample. A titer of ≥ 160 was used 160 to define a seropositivity reaction, no positive results have been observed for the following 5 161 serogroups as Ballum, Bataviae, Canicola, Pomona and Tarassovi. The results revealed that 162 Leptospira serogroups Grippotyphosa and Australis were the most prevalent with respectivly 163 17/42 and 13/42 positive MAT (Table III). 164 165 Leptospira interrogans spp. (RT-PCR) 166 Of the 26 organ samples analysed, DNA of pathogenic Leptospira was detected in 21 167 cases. Among the 21 PCR positive cases, 5 sera were negative by MAT against the 24 serovars 168 (14 serogroups) tested. 169 Concerning the 5 PCR negative cases, a positive MAT was observed in 4 samples. For 170 only one sample, the PCR and the MAT were negative. The results of serology (MAT) and 171 molecular detection (real-time PCR) tests are summarized in Table III. 7 172 173 Leptospira MLST genotyping 174 Among the 10 samples, 2 were successfully amplified and sequenced for all the 7 loci. 175 For these two samples, different sequence types (ST) were obtained, the ST number 110 profile 176 for sample CI-14-061536-002 and the ST number 24 profile for sample CI-12-000889-002 177 (Table III). In the Leptospira MLST database, ST number 110 profile corresponds to 178 Leptospira kirschneri species and Grippotyphosa serogroup (Table III), whereas the ST 179 number 24 profile corresponds to Leptospira interrogans species and Australis serogroup 180 (Table III). 181 182 DISCUSSION 183 MAT and PCR results support the hypothesis that the jaundice observed in fetuses was 184 due to leptospiral infection. Furthermore, no other cause of abortion was identified despite the 185 wide range of analyzes. 186 The MAT is the serological reference test, particularly appropriate for carrying out 187 epidemiological studies, since it can be applied to sera from any animal species, and because 188 the range of antigens utilized can be expanded or decreased as required (Levett, 2004). Most 189 cases of leptospirosis are diagnosed by serology and antibodies are detectable in the blood 190 approximately 5 to 7 days after the onset of clinical signs. In our conditions, the sampling was 191 performed at the time of abortion but the presence of jaundice indicated an earlier infection that 192 could explain the relative high titer in MAT observed. 193 Australis and Grippotyphosa are identified as the two predominant serogroups in this 194 study. These results are consistent with the findings of two other recent studies, in Germany 195 concerning dogs (Mayer-Scholl et al., 2013) and in France concerning dogs and cattle (Ayral 196 et al., 2014). In France, the two predominant infecting serogroups involved in clinical bovine 8 197 and canine leptospirosis from 2008 to 2011 are also Australis and Grippotyphosa for the two 198 species. 199 On average, sera show a seropositive reaction to two serogroups with a maximum of 200 five. Indeed, MAT is a complex test to control, perform, and interpret. It is a serogroup-specific 201 assay but interpretation of the MAT is complicated by the high degree of cross-reaction that 202 occurs between different serogroups, especially in acute-phase samples. This “paradoxical” 203 reaction, in which the highest titers are detected to a serogroup unrelated to the infecting one, 204 are also common and studied (Blanco et al., 2016; Lin et al., 1997). The broad cross-reactivity 205 in the acute phase is followed by relative serogroup specificity in convalescent-phase samples 206 (Levett, 2001). Than, an average of two serogroups per sample seems relatively high compared 207 to other studies where only one serovar is highlighted. But this observation argues for 208 paradoxical reaction due to IgM during acute infection. Unfortunatly, paired sera are not 209 available to confirm the infected serogroup with certainty. Moreover, a positive result does not 210 identify with certainty the cause of abortions and it is impossible to date the infection, the 211 reaction kinetics with respect to different serovars may vary (Levett, 2001). 212 In order to ensure the involvement of bacteria in the abortive process, PCR were 213 performed and bacterial DNA was detected in the great majority of cases. Following these PCR 214 analyzes, different profiles combining PCR and MAT are observed. These profiles may depend 215 on the delay between the infection and the abortion, the immunity of the infected animals, the 216 type of serogroups concerned or the laboratory assays. 217 In total, in the great majority of cases, both analyzes provide a positive response and support 218 the diagnosis of leptospirosis. 219 Because of the difficulties associated with serological identification of leptospiral 220 isolates, there has been great interest in molecular methods for identification and subtyping 221 (Terpstra, 1992; Herrmann, 1993). The reclassification of leptospires on genotypic grounds is 9 222 taxonomically correct and provides a strong foundation for future classifications. Genotyping 223 of two species of Leptospira is a key point that allows knowing with certainty the infecting 224 species. Leptospira interrogans and Leptospira kirschneri were genotyped and have a positive 225 response to serogroup Australis and Grippotyphosa respectively. These results are consistent 226 with Leptospira MLST database. 227 During this episode in 2014, many questions arise about the almost simultaneous 228 distribution on a broad territory of a disease that does not have the dissemination power of an 229 arbovirus. The disease is maintained in nature by chronic infection of reservoir hosts. The most 230 important reservoir hosts are small mammals, which may transfer infection to domestic farm 231 animals, dogs, and humans. Different rodent species may act as reservoir of the serogroups 232 highlighted in this study (Levett, 2001). Distinct variations in reservoir hosts and the serovars 233 they carry occur throughout the world (Hartskeerl and Terpstra, 1996). Currently, the source of 234 infection remains unknown and therefore complicates the usefulness of implementation of 235 preventive measures. From the affected farms, only one case of bovine aborted fetus was 236 identified in 95% of the farms with a maximum of 3 cases in one farm (Delooz et al., 2015). 237 That allows hypothesizing that infection does not spread to the entire herd by other cattle that 238 therefore do not appear to be potential maintenance hosts. 239 The spectrum of clinical signs is extremely broad. Formerly it was considered that 240 distinct clinical syndromes were associated with specific serogroups. However, this hypothesis 241 was questioned by some authors and following studies refuted this hypothesis (Levett, 2001). 242 Grippotyphosa and Australis are the two main serogroups revealed during this emerging event 243 associated with the same clinical pattern, which joins the idea that clinical syndromes were not 244 associated with specific serogroups. However, congenital jaundice from aborted fetuses coming 245 from clinically healthy cows is a new clinical sign to add to those caused by pathogenic 246 Leptospira. 10 247 The results of this study indicated that Sejroe serogroup was rarely diagnosed and that 248 methods of the diagnosis of leptospirosis must be adapted for a better surveillance and control. 249 This finding suggests that the available bovine vaccine targeting this serogroup is capable of 250 preventing a minority of the clinical cases. Nevertheless, additional serogroups, such as 251 Grippotyphosa and Australis should be included in the vaccine to eliminate most Leptospira- 252 related diseases in cattle. 253 254 CONCLUSION 255 256 Jaundice was a known clinical sign of leptospirosis but, to our kowledge, had never been 257 diagnosed in bovine aborted fetuses coming from clinically healthy cows in the literature. This 258 work allows the association of two pathogenic Leptospira species (L. interrogans or L. 259 kirschneri) to congenital jaundice in bovine aborted fetuses. This new clinical sign should be 260 added to the clinical picture of bovine leptospirosal abortion. 261 Leptospira are often difficult to isolate from infected cattle and therefore diagnosis 262 usually depends on the detection of specific antibodies. This work showed a feasible method of 263 direct diagnostic approach under field conditions where the veterinary practitioner performs 264 samples in cattle farms. 265 Finally, despite that the sources of infection during the emergence remain unknow, this 266 study provided useful information in the knowledge of bovine leptospirosis in south part of 267 Belgium. It seems necessary to be prepared to tackle appropriate prevent and control measures 268 and to further explores the epidemiology of this disease in this region, especially in wild life. 269 270 AKNOWLEDGEMENT 11 271 We thank Magnée D. (Thermofisher, UK) to provide PCR kits. We thank the Federal Agency 272 for the Safety of the Food Chain (FAFSC) to support the costs of the basic protocol 273 corresponding to the standardized panel of analyses. The authors gratefully acknowledge their 274 veterinary colleagues from ARSIA, i.e. Christian Quinet (serology), Marc Saulmont and 275 Thierry Petitjean (autopsy and microbiology) for their technical assistance. 276 277 REFERENCES 278 Adler, B., 2010: Leptospira and Leptospirosis. Current Topics in Microbiology and 279 Immunology 387: 1–293. 280 Ayral, F. C., D. J. Bicout, H. Pereira, M. Artois, and A. Kodjo, 2014: Distribution of Leptospira 281 serogroups in cattle herds and dogs in France. 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List of pathogens included and diagnostic methods applied in the standardized panel 354 of analyses Fetus Foetal serum Maternal serum Methods Methods Pathogens Samples Methods Abomasal fluid Culture Campylobacter foetus spp. Abomasal fluid Culture Coxiella burnetii Abomasal fluid PCR** Listeria monocytogenes Abomasal fluid Culture Mycotic agents Abomasal fluid Culture Opportunistic bacteria Abomasal fluid Culture $ Salmonella spp. Abomasal fluid Culture BTV-8 Brain PCR* Neospora caninum Brain PCR Schmallenberg virus Brain PCR* BoHV-4 Spleen PCR ELISA Ab BVDV Spleen ELISA Ag ELISA Ab Brucella spp. SAW /ELISA Ab ELISA Ab ELISA Ab ELISA Ab 15 Leptospira serovar Hardjo ELISA Ab 355 356 Legend: PCR, Polymerase chain reaction; Ab, Antibody; Ag, Antigen; SAW, Sero- 357 agglutination of Wright; $, Only the presence of a pure culture on blood agar is indicative of 358 opportunistic bacteria; *, Applied only if suspected case (congenital abnormalities); BVDV, 359 Bovine Viral Diarrhoea Virus; BTV-8, Bluetongue virus serotype 8; BoHV-4, Bovine 360 herpesvirus 4. 361 16 362 363 364 Table II. Distribution of MAT results among the tested cow sera according to different leptospiral serogroup (only serogroups with positive results are listed) Titer Grippotyphosa Australis Negative 25 1/160 4 1/320 3 1/640 4 1/1280 6 Total positive 17 Total sera tested 42 365 29 2 2 5 4 13 42 IcteroAutumnalis Panama Pyrogenes Sejroe Cynopteri Hebdomadis haemorrhagiae 36 4 2 6 42 35 2 3 1 1 7 42 37 2 3 5 42 40 1 1 2 42 39 2 39 3 41 1 1 3 42 3 42 1 42 366 Table III. Results of serological and antigenical analysis according to Leptospira serogroup 367 (only serogroups with positive results are listed, the highest titer of each serogroup is presented) Leptospiral serogroup ID CI-11-023436 CI-11-029715 CI-12-000889 CI-12-001123 CI-13-006899 CI-13-011101 CI-13-018383 CI-13-019237 CI-13-022971 CI-13-032292 CI-13-032707 CI-14-034435 CI-14-034966 CI-14-037270 CI-14-038297 CI-14-038323 CI-14-038596 CI-14-040708 CI-14-042496 CI-14-042765 CI-14-044328 CI-14-044569 CI-14-044707 CI-14-046867 CI-14-047394 CI-14-047531 CI-14-047968 CI-14-048785 CI-14-049712 CI-14-050512 CI-14-050870 CI-14-057066 CI-14-057564 CI-14-057925 CI-14-058607 CI-14-058713 CI-14-061536 CI-14-062221 CI-14-063728 CI-14-065178 Pathogenic Leptospira strains (PCR) Pos Genotyping (MLST) L. interrogans Pos Pos Neg Pos Neg Neg Pos Pos Pos Pos Pos Pos Pos Pos Neg Pos Pos Pos Pos Pos Pos Pos Pos * L. kirschneri * * AUS AUT CYN GRI HEB ICT PAN PYR SEJ 640 160 1280 320 1280 160 640 1280 1280 640 640 320 - - 640 320 - 160 - 320 - 640 - 160 - 160 1280 160 - 160 - 160 1280 - 160 640 - 320 - 160 - 160 - 640 160 - 320 - 1280 - 640 - 160 1280 - 1280 320 - 160 320 - 320 - 160 640 - 320 640 - 160 - 640 - 1280 - 1280 - 1280 - 160 - 160 - CI-14-067483 CI-14-069253 368 Pos Neg 640 320 - - 320 - - - - - 369 Legend: 370 * Unsuccessful amplification and sequencing; AUS, Australis ; AUT, Autumnalis ; CYN, 371 Cynopteri ; GRI, Grippotyphosa; HEB, Hebdomadis; ICT, Icterohaemorrhagiae ; PAN, Panama 372 ; PYR, Pyrogenes ; SEJ, Sejroe. 373 2 374 Figure captions 375 Figure 1. Geographical distribution of icteric abortion's case, years 2008-2014 (N=152) 376 Legend: White dots correspond to icteric cases where complementary analysis (MAT and/or 377 RT-PCR) are performed; black dots corresponds to icteric cases without complementary 378 analysis. 379 380 Figure 2. Trends of icteric bovine aborted fetuses rate and the absolute number of notified 381 abortions 382 3 383 Fig. 1 384 385 4 386 Fig. 2 387 388 389 5